Beyond the Checklist: Addressing Shortfalls in National Pandemic Influenza Preparedness

[Sep 27 Washington DC]--Mr. Chairman, Ranking Member McCaul and Members of the Subcommittee:
Thank you for the opportunity to testify before the Subcommittee to discuss the progress of the National Strategy for Pandemic Influenza and its Implementation Plan. I am Dr. Til Jolly, Associate Chief Medical Officer for Medical Readiness, within the Office of Health Affairs at the Department of Homeland Security (DHS). Before I begin, I would like to take this opportunity to thank you and Members of the full Committee on behalf of Secretary Chertoff for your continued willingness to work alongside the Department to provide leadership in protecting and ensuring the security of our homeland. I would also like to thank our partners at the Department of Health and Human Services (HHS) and others with whom we work every day.
To begin, I would like to take a few moments to review some basic facts about pandemics and their potential impacts on our nation. Pandemic influenza occurs when a novel strain of influenza virus emerges that has the ability to infect humans and to cause severe disease, and when efficient and sustained transmission between humans occurs. This scenario creates unique challenges. Unlike other incidents, a pandemic is not a singular event, but is likely to come in waves, each lasting weeks or months, passing through communities of all sizes across the nation and the world simultaneously. The complete pandemic cycle may last as long as 18 months. Based on projections modeled by the Department of Health and Human Services from prior pandemics, an influenza pandemic could result in 200,000 to 2 million deaths in the United States, depending on its severity. Further, an influenza pandemic could have major impacts on society and the economy, including our nation's critical infrastructure and key resources, as many of our nation's workforce could be absent for extended periods of time, either sick themselves or caring for loved ones at home.
The Implementation Plan for the National Strategy for Pandemic Influenza was released over a year ago by the President's Homeland Security Council to guide our nation's preparedness and response to an influenza pandemic. DHS has been actively engaged with its federal, state, local, territorial, tribal, and private sector partners to prepare our nation and the international community for an influenza pandemic. As outlined in the Implementation Plan DHS is responsible for the coordination of the overall domestic Federal response during an influenza pandemic, including implementation of policies that facilitate compliance with recommended social distancing measures, development of a common operating picture for all Federal departments and agencies, and ensuring the integrity of the Nation's infrastructure, domestic security and entry and exit screening for influenza at the borders.
To date DHS has accomplished over 80% of the requirements outlined in the Implementation Plan. DHS recognizes the key role of HHS in its responsibilities to lead clinical disease surveillance and rapid detection during a pandemic, and, under Emergency Support Function (ESF)-8, to plan, prepare, mitigate and support the coordination of the public health and medical emergency response activities during a pandemic under ESF-8, including the deployment and distribution of vaccines and of anti-virals and other life-saving medical countermeasures from the Strategic National Stockpile. DHS also recognizes the Department of State's role to lead the coordination of international efforts including U.S. engagement in a broad range of bilateral and multilateral initiatives that build cooperation and capacity to fight the spread of avian influenza, to prepare for a possible pandemic, and to coordinate with our neighbors Canada and Mexico. The Department of Agriculture (USDA) conducts surveillance for influenza in domestic animals and animal products, monitoring wildlife in partnership with the Department of the Interior, and working to ensure an effective veterinary response to a domestic animal outbreak of highly pathogenic avian influenza.
In working with our partners DHS has developed and implemented a number of initiatives and outreach to support continuity of operations planning for all levels of government and private sector entities. I will highlight a few noteworthy accomplishments and responsibilities under the Implementation Plan particular to DHS. DHS produced and released the Pandemic Influenza Preparedness, Response, and Recovery Guide for Critical Infrastructure and Key Resources (Guide). Tailored to national goals and capabilities, and to the specific needs identified by the private sector, this business continuity guidance represents an important first step in working with the owners and operators of critical infrastructure to prepare for a potentially severe pandemic outbreak. The Guide has served to support business and other private sector pandemic planning by complementing and enhancing, not replacing, their existing continuity planning efforts. With that in mind, the Federal government developed the Guide to assist businesses whose existing continuity plans generally do not include strategies to protect human health during emergencies such as those caused by pandemic influenza or other diverse natural and manmade disasters.
DHS is currently leading the development of specific guides for each of the 17 critical infrastructure and key resource sectors. These include agriculture, food, and water, public health, emergency services, telecommunications, banking, defense systems, transportation, energy resources, and others. These guides are being developed utilizing the security partnership model and in collaboration with our Federal partners.
In coordination with other Federal departments and agencies, DHS is developing a coordinated government-wide planning forum. An initial analysis of the response requirements for Federal support has been completed. From this analysis, a national plan defining the federal concept for coordinating response and recovery operations during a pandemic has been developed and will be undergoing interagency review. Utilizing this planning process, a coordinated federal border management plan has been developed and is currently in review. This process included state, local, tribal, territorial, and private sector stakeholder input, along with our Federal interagency partners.